Ricci Zaccaria, Ronco Claudio
Department of Pediatric Cardiosurgery, Bambino Gesù Hospital, Rome, Italy.
Blood Purif. 2009;27(1):127-34. doi: 10.1159/000167019. Epub 2009 Jan 23.
The present review describes recent evidence on all aspects relating to acute kidney injury (AKI): epidemiology, definition, diagnosis, medical and extracorporeal therapy. AKI is often underrecognized, but its outcome still remains unfavorable. In this light, definition, classification and diagnosis of AKI are fundamental today and may be reliably based on recently proposed RIFLE (risk, injury, failure, loss of function, end-stage kidney disease) classification. Pharmacological therapy of AKI is still scarcely effective, but renal replacement therapy has progressed to a more accurate and safe treatment and new interesting high-level trials and observational studies have been performed and are reviewed and commented. In the near future, however, only increased awareness of AKI incidence and early treatment or prevention of kidney injury progression will hopefully improve outcome of critically ill patients with renal failure.
本综述描述了与急性肾损伤（AKI）各方面相关的最新证据：流行病学、定义、诊断、药物治疗和体外治疗。AKI常常未得到充分认识，但其预后仍然不佳。鉴于此，AKI的定义、分类和诊断如今至关重要，并且可以可靠地基于最近提出的RIFLE（风险、损伤、衰竭、功能丧失、终末期肾病）分类。AKI的药物治疗仍然效果不佳，但肾脏替代治疗已发展为一种更精确、更安全的治疗方法，并且已经开展了一些新的、有趣的高水平试验和观察性研究，并对其进行了综述和评论。然而，在不久的将来，只有提高对AKI发病率的认识以及早期治疗或预防肾损伤进展，才有望改善重症肾衰竭患者的预后。
